The description of a modified technique of gastrostoma formation on small flexure is presented. Indications for this operation in patients with tumor and cicatrical esophageal strictures, planned for gastric esophagoplasty are formulated. The are authors regard a correctly created gastrostoma as the first stage of esophagoplasty. The main mistakes in gastrostoma creation that donTt permit to use the stomach for esophagus replacement are noted. The main principles and techniques of stoma creation on small flexure are described. The presented method is recommended for use in specialized esophageal departments and in general surgical hospitals.